gms | German Medical Science

Objectives: Hip fractures are a significant cause of mortality and morbidity in the elderly. This study investigated the relationship between initial haemoglobin (Hb) levels and a prognostic parameter for outcome in those patients.

Methods: A total of 3,595 consecutive patients with diagnosed hip fractures were studied with 72.2% being female. Follow up was 11.2±0.3 months and age group was divided in under84 years (60.1%) and over85 years (39.9%). Mortality <12 months was n=439, (12.2%). Anaemia was defined according to WHO criteria, with subgroups mild, moderate and severe anaemia. Data collection was performed prospectively and statistical evaluation was performed retrospectively.

Results and Conclusion: In our study population Hb levels ad admission showed a statistical significant direct correlation to short term mortality. Lower Hb levels ad admission were associated with higher short term mortality. Mild anaemia at admission caused a 1.5 (CI: 1.1-1.9), moderate anaemia a 2.6 (95 CI: 2.0-3.4), and severe anaemia a 3.6 (CI:1.8-6.9) increase in three months mortality. Total lymphocyte count (1.2±0) did not show any differences between the subgroups.

Those findings in our study population with 3,595 patients over a period of twenty years, have proven that initial Hb levels are a useful and cost effective parameter to predict mortality in elderly patients with a hip fracture. This prognostic factor may help to increase the outcome of elderly patients treated with a hip fracture.